The Threat of Antimicrobial Resistance: Towards a Global Health Crisis by 2050

In 2021, antimicrobial resistance (AMR) was responsible for 4.71 million deaths. If we do not act, it will be the leading cause of global mortality by 2050.

Research published by The Lancet shows that 4.71 million people lost their lives due to antimicrobial resistance (AMR) in 2021. In twenty-four percent of these deaths, AMR was not a complication of a pre-existing condition, but the direct cause of death.

What does this mean? That certain micro-organisms, such as bacteria, no longer respond to antimicrobial treatments designed to eliminate them, including antibiotics. The main cause is the inappropriate and excessive use of antibiotics and other antimicrobials in both humans and animals. This has led to some diseases spreading more rapidly, becoming more difficult to treat and, in severe cases, proving fatal. In fact, antimicrobial resistance is predicted to become the leading cause of death worldwide.

A grim future: 70% more deaths from AMR by 2050

According to The Lancet study, AMR could be linked to 8.22 million deaths per year by 2050, of which 1.91 million would be directly attributable to antimicrobial-resistant bacterial infections. This scenario represents a 69.6% increase in AMR-related deaths between 2022 and 2050. The hardest hit regions would be South Asia and Latin America and the Caribbean, particularly among people aged over 70, where the increase in mortality could reach 65.9%. In addition, disability due to AMR is estimated to increase by 9.4%.

Latest data: improvement in children, worsening in older adults.

However, the same study also provides positive data: between 1990 and 2021, mortality due to antimicrobial resistance in children under 5 years of age fell by more than 50%. On the other hand, deaths in adults over 70 years of age increased by more than 80%. This increase in mortality affected people over the age of 5 in all regions studied. One of the most problematic infectious agents was methicillin-resistant Staphylococcus aureus bacteria, the number of deaths associated with which almost doubled from 261,000 in 1990 to 550,000 in 2021. A worrying increase in resistance to carbapenems, a class of antibiotics used as a last resort for serious infections, was also reported.

The study shows that resistance to carbapenems has increased more than to any other class of antibiotics, with deaths from Gram-negative bacteria resistant to these drugs rising from 619,000 in 1990 to 1.03 million in 2021.

A hopeful future is still possible

Despite this discouraging outlook, the report points to an optimistic possibility: if the management of serious infections is improved and access to antimicrobials is made easier, up to 92 million deaths could be avoided between 2025 and 2050. To reach that ideal scenario, major hurdles will need to be overcome, including the high costs of research and development of new antimicrobials, as well as the slow approval process for new treatments.

The time to act is now

To mitigate the devastating consequences of AMR expected by 2050, we need a holistic strategy that combines key interventions. These include infection prevention, vaccination, responsible use of antibiotics in agriculture and human health, and investment in the development of new antimicrobials. If we are to meet the target of reducing mortality from resistant bacterial infections by 10% by 2030, these measures must be implemented with vigour.

At ISGlobal we are working in this direction through the research groups and the RAM initiative, participating in international projects such as AMREDUCare, recognized for its global impact and supported by studies such as The Lancet, to prevent and combat antimicrobial resistance on all fronts.